Tension Band Wiring of Patella Fractures: Mid-Term Radiological and Clinical Results

Authors : Furkan YAPİCİ, Volkan GÜR, İzzet Özay SUBAŞI, Reşit KARAKÖSE, Nizamettin KOÇKARA

Pages : 528-536

Doi:10.31067/acusaglik.1131386

View : 23 | Download : 9

Publication Date : 2022-10-01

Article Type : Research Paper

Abstract :Objective: We aimed to share our radiological and clinical results with a mid-term follow-up on patella fractures treated with tension band wiring insert ignore into journalissuearticles values(TBW);. Methods: Patients surgically treated with TBW for AO type 34-A1/C1/C2/C3 patella fractures between January 2013 and June 2021 at a level 1 trauma center were included. For radiological evaluation, radiographs obtained at the routine follow-up were analyzed for complications insert ignore into journalissuearticles values(such as nonunion, malunion, loss of reduction, malreduction, patella baja, elongated patella, implant failure);, Insall-Salvati Index insert ignore into journalissuearticles values(ISI);, and Patellar Morphology Ratio insert ignore into journalissuearticles values(PMR);. The Knee Injury and Osteoarthritis Score insert ignore into journalissuearticles values(KOOS); was utilized for functional evaluation, which includes five subscales: pain, symptoms, activities of daily living insert ignore into journalissuearticles values(ADL);, sports/recreation, and quality of life insert ignore into journalissuearticles values(QOL);. The clinical assessment also included the range of motion insert ignore into journalissuearticles values(ROM);, thigh circumference insert ignore into journalissuearticles values(TC);, and complications such as implant irritation insert ignore into journalissuearticles values(II);. Results: This study reviewed 42 eligible patients insert ignore into journalissuearticles values(10 females, 32 males); with a mean age of 42.6 ± 16.1 years and a mean follow-up of 35.4 ± 24.1 months. There were 28 patients insert ignore into journalissuearticles values(66.7%); with at least one complication insert ignore into journalissuearticles values(II: 66.7%, flexion deficit: 61.9%, malunion: 40.5%, elongated patella/patella baja: 16.7%);. The reoperation rate was high at 69.1% due to the high implant removal rate for II. There were statistically significant differences between injured insert ignore into journalissuearticles values(I); and uninjured contralateral healthy knees insert ignore into journalissuearticles values(UI); in terms of mean KOOS subscale scores insert ignore into journalissuearticles values(symptoms: I: 72.3, UI: 89.8; pain: I: 70.4, UI: 89.4; ADL : I: 72.1, UI: 90; sports: I: 61.4, UI: 84.8; QOL: I: 67.9, UI: 86.2);, mean flexion degrees insert ignore into journalissuearticles values(I: 126.2°, UI: 135.4°);, mean ISI insert ignore into journalissuearticles values(I: 0.9, UI: 1.0);, and mean PMR insert ignore into journalissuearticles values(I: 1.5, UI: 1.4); insert ignore into journalissuearticles values(all p 0.05);. All fractures achieved union. Conclusion: Firstly, the mid-term clinical results of patellar fractures treated with TBW were significantly worse than the contralateral healthy knee; secondly, implant irritation, knee flexion deficit, malunion, and patella baja were the significant complications, and efforts should be made to manage these problems; thirdly, patellar fractures are susceptible to developing interesting cases of the elongated patella.
Keywords : Patella fracture, Tension band wiring, Radiological and clinical results, Complications, Implant irritation, Flexion deficit, Malunion, Patella baja, Elongated patella, Malreduction, Implant fail